Objective: Cardiac rupture is a catastrophic but uncommon complication of acute ST-segment elevation myocardial infarction (STEMI). In today's era, the incidence and risk factors associated with cardiac rupture are unclear, and the purpose of this study was to investigate the risk factors for complications of cardiac rupture. Methods: From June 2019 to June 2022, 416 patients with STEMI admitted From June 9 to June 2022, 416 patients with STEMI admitted to the Department of Cardiovascular Medicine of the First People's Hospital of Jingzhou City were selected, and the clinical characteristics of patients with STEMI and patients with concomitant cardiac rupture were collected and analyzed. Results: Twenty-six (6.3%) cardiac ruptures were clinically confirmed, including 23 (6.3%) cardiac ruptures in patients with STEMI and patients with concomitant cardiac rupture. clinically confirmed, including 23 (88.5%) left ventricular free wall ruptures and 3 (11.5%) ventricular septal ruptures, of which 14 (53.8%) were Binary logistic regression analysis showed that women (OR:4.82, 95% CI: 2.143 to 10.843, P=0) and older age (OR:1.066, 95% CI: 1.014 to 1.121, P=0.012) increased the risk of cardiac rupture, while effective pPCI (OR:0.146, 95% CI: 0.057 to 0.379, P=0) helped prevent cardiac Smoking (OR:0.092, 95% CI: 0.021 to 0.403, P=0.002) appeared to reduce the risk of cardiac rupture complicated by STEMI. Conclusion: In this study women, old age, and low pPCI reperfusion therapy increased the risk of cardiac rupture complicating STEMI, so early prevention and treatment should be achieved.

Hao Chen, Shaning Yang. Analysis of Risk Factors for Acute ST-segment Elevation Myocardial Infarction Complicated by Cardiac Rupture. Frontiers in Medical Science Research (2022) Vol. 4, Issue 14: 37-42. https://doi.org/10.25236/FMSR.2022.041405.

[1] FIGUERAS J, ALCALDE O, BARRABES J A, et al. Changes in hospital mortality rates in 425 patients with acute ST-elevation myocardial infarction and cardiac rupture over a 30-year period [J]. Circulation, 2008, 118(25): 2783-9.

[2] FRENCH J K, HELLKAMP A S, ARMSTRONG P W, et al. Mechanical complications after percutaneous coronary intervention in ST-elevation myocardial infarction (from APEX-AMI) [J]. The American journal of cardiology, 2010, 105(1): 59-63.

[3] CHANG R-Y, TSAI H-L, HSIAO P-G, et al. Comparison of the risk of left ventricular free wall rupture in Taiwanese patients with ST-elevation acute myocardial infarction undergoing different reperfusion strategies: A medical record review study [J]. Medicine, 2016, 95(44): e5308.

[4] LOPEZ-SENDON J, GURFINKEL E P, LOPEZ DE SA E, et al. Factors related to heart rupture in acute coronary syndromes in the Global Registry of Acute Coronary Events [J]. European Heart Journal, 2010, 31(12): 1449-56.

[5] UERTO E, VIANA-TEJEDOR A, MARTINEZ-SELLES M, et al. Temporal Trends in Mechanical Complications of Acute Myocardial Infarction in the Elderly [J]. J Am Coll Cardiol, 2018, 72(9): 959-66.

[6] BIRNBAUM Y, FISHBEIN M C, BLANCHE C, et al. Ventricular septal rupture after acute myocardial infarction [J]. The New England journal of medicine, 2002, 347(18): 1426-32.

[7] MOREYRA A E, HUANG M S, WILSON A C, et al. Trends in incidence and mortality rates of ventricular septal rupture during acute myocardial infarction [J]. The American journal of cardiology, 2010, 106(8): 1095-100.

[8] ELBADAWI A, ELGENDY I Y, MAHMOUD K, et al. Temporal Trends and Outcomes of Mechanical Complications in Patients with Acute Myocardial Infarction [J]. JACC Cardiovasc Interv, 2019, 12(18): 1825-36.

[9] HAO Z, MA J, DAI J, et al. A real-world analysis of cardiac rupture on incidence, risk factors and in-hospital outcomes in 4190 ST-elevation myocardial infarction patients from 2004 to 2015 [J]. Coron Artery Dis, 2020, 31(5): 424-9.

[10] FU Y, LI K-B, YANG X-C. A risk score model for predicting cardiac rupture after acute myocardial infarction [J]. Chin Med J (Engl), 2019, 132(9): 1037-44.

[11] MENON V, WEBB J G, HILLIS L D, et al. Outcome and profile of ventricular septal rupture with cardiogenic shock after myocardial infarction: a report SHould we emergently revascularize Occluded Coronaries in cardiogenic shocK? [J]. Journal of the American College of Cardiology, 2000, 36(3 Suppl A): 1110-6.

[12] CRENSHAW B S, GRANGER C B, BIRNBAUM Y, et al. Risk factors, angiographic patterns, and outcomes in patients with ventricular septal defect GUSTO-I (Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries) Trial Investigators [J]. Circulation, 2000, 101(1): 27-32.

[13] MARKOWICZ-PAWLUS E, NOZYŃSKI J, SEDKOWSKA A, et al. Cardiac rupture risk estimation in patients with acute myocardial infarction treated with percutaneous coronary intervention [J]. Cardiol J, 2007, 14(6): 538-43.

[14] BUENO H, MARTINEZ-SELLES M, PEREZ-DAVID E, et al. Effect of thrombolytic therapy on the risk of cardiac rupture and mortality in older patients with first acute myocardial infarction [J]. Eur Heart J, 2005, 26(17): 1705-11.

[15] GAO X M, WHITE D A, DART A M, et al. Post-infarct cardiac rupture: recent insights on pathogenesis and therapeutic interventions [J]. Pharmacol Ther, 2012, 134(2): 156-79.

[16] KOERSELMAN J, DE JAEGERE P P T, VERHAAR M C, et al. Coronary collateral circulation: the effects of smoking and alcohol [J]. Atherosclerosis, 2007, 191(1): 191-8.

[17] Birnbaum Y, Fishbein MC, Blanche C, Siegel RJ. Ventricular septal rupture after acute myocardial infarction. N Engl J Med. 2002 Oct 31; 347(18):1426-32.

[18] Moreno, Raúl et al. “Primary angioplasty reduces the risk of left ventricular free wall rupture compared with thrombolysis in patients with acute myocardial infarction.” Journal of the American College of Cardiology vol. 39, 4 (2002): 598-603. 

[19] WEI T F, ZHAO B, LIU P L, et al. [Impact of symptom onset to first medical contact time on the prognosis of patients with acute ST-segment elevation myocardial infarction] [J]. Zhonghua Xin Xue Guan Bing Za Zhi, 2017, 45(5): 393-8.

[20] Gao XM, Tsai A, Al-Sharea A, Su Y, Moore S, Han LP, Kiriazis H, Dart AM, Murphy AJ, Du XJ. Inhibition of the Renin-Angiotensin System Post Myocardial Infarction Prevents Inflammation-Associated Acute Cardiac Rupture. Cardiovasc Drugs Ther. 2017 Apr; 31(2):145-156.